Beyond Physical Toxicities: Identifying Psychosocial Domains Requiring Integrated Support in Breast Cancer...

Cancer pharmacotherapy imposes substantial physical and psychosocial burdens that affect patients' quality of life (QoL). While oncologic outcomes are well studied, the psychological dimensions-particularly future perspective, emotional resilience, and body image-remain underintegrated into routine care. The growing recognition of psycho-oncology highlights the need for synergistic collaboration between oncology and clinical psychology.

To evaluate changes in QoL before and after pharmacotherapy among women with breast cancer and identify domains most vulnerable to psychological distress, thereby informing the need for integrated psycho-oncologic care.

This prospective study included 106 women with breast cancer undergoing pharmacotherapy. Sociodemographic and clinical characteristics were collected, including cancer stage, treatment modalities, and baseline cardiometabolic parameters. QoL was assessed pre- and post-treatment using EORTC QLQ-C30 and BR23 instruments. Paired comparisons were performed using Wilcoxon signed-rank tests, and correlations with age were analyzed using Spearman or Pearson methods as appropriate.

Global health status declined significantly after pharmacotherapy (83.3 to 66.7; p = 0.002). Functional domains-including physical, role, and social functioning-also worsened, while emotional functioning improved modestly. Symptom burden increased across fatigue, nausea, pain, appetite loss, and systemic side effects (all p < 0.001). Breast-cancer-specific domains such as body image and future perspective showed minimal change but remained highly variable, indicating psychosocial vulnerability. Distress related to hair loss demonstrated a modest inverse correlation with age (r = -0.296; p = 0.003).

Pharmacotherapy substantially reduces multiple QoL domains, highlighting symptom-function trade-offs and persistent psychological concerns. The patterns in emotional functioning and future perspective indicate unmet psychosocial needs. These findings underscore the imperative for integrated psycho-oncology models to enhance holistic survivorship care.